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Microalbuminuria: a marker of systemic endothelial dysfunction during burn excision
E Vlachou1, P Gosling, N S Moiemen
1Burns and Plastic Surgery Department, University Hospital Birmingham, NHS Foundation Trust, UK. lilly@doctors.org.uk
Burns : Journal of the International Society for Burn Injuries
|August 19, 2007
Summary
Systemic endothelial dysfunction, monitored by urine albumin (microalbuminuria), recurs during burn surgery. Levels are influenced by excised burn area and post-operative complications, being lowest 2-7 days post-injury.
Area of Science:
- Burn injury research
- Endothelial dysfunction
- Clinical immunoassay
Background:
- Systemic endothelial dysfunction is common in burn injury and surgery.
- Urine albumin (microalbuminuria) is a marker for endothelial dysfunction.
- This study investigated microalbuminuria during burn excision.
Purpose of the Study:
- To assess microalbuminuria before and during burn excision.
- To identify factors influencing microalbuminuria in burn patients.
Main Methods:
- Serial urine albumin/creatinine ratio (ACR) measured half-hourly in 25 adult patients.
- 44 burn-excision procedures were analyzed.
- Median excised total body surface area (TBSA) was 12%.
Main Results:
- Pre-operative ACR was normal, increasing during surgery (p<0.05).
- Intraoperative ACR correlated with % TBSA excised (p<0.04).
- ACR varied significantly based on time of surgery post-injury and correlated with CRP and post-operative complications.
Conclusions:
- Microalbuminuria indicates recurring endothelial dysfunction during burn surgery.
- Endothelial dysfunction is minimal 2-7 days post-burn.
- Factors influencing microalbuminuria include % TBSA excised and post-operative complications.
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